scispace - formally typeset
Search or ask a question
Journal ArticleDOI

Low nutrient intake among adult women and patients with severe tuberculosis disease in Uganda: a cross-sectional study

TL;DR: Findings suggest that severity of pulmonary tuberculosis and female gender had reduced nutrient intake, and early tuberculosis diagnosis and nutritional support may be important in management of tuberculosis patients.
Abstract: Information regarding dietary nutrient intake during tuberculosis disease is lacking. We established the relationship between disease severity or wasting during pulmonary tuberculosis and nutrient intake. In a cross-sectional study of 131 adults with or without pulmonary tuberculosis were screened for human immune-deficiency virus (HIV), wasting, disease severity using 13 item validated clinical TBscore, and 24-hour dietary intake recall. Of the 131 participants, 61 were males and 70 females. Overall men and women had similar age. In average 24-hour nutrient intake, the following nutrients: energy, protein, total fat, carbohydrate, calcium, vitamin A, and folate were low among patients with severe tuberculosis disease. Patients with moderate-to-severe clinical TBscore had lower average energy intake than patients with mild TBscores (6.11 vs. 9.27 MJ, respectively) (p<0.05). The average 24-hour nutrient intakes between wasted and non-wasted tuberculosis patients were comparable. Nutrient intake among men was higher when compared to women regardless of wasting and severity of tuberculosis. Among those with wasting, men had higher average energy intake than women (8.87 vs. 5.81 MJ, respectively) (p<0.05). Among patients with mild disease, men had higher average energy intake than women with mild disease (12.83 vs. 7.49 kcal, respectively) (p<0.001). Findings suggest that severity of pulmonary tuberculosis and female gender had reduced nutrient intake. Early tuberculosis diagnosis and nutritional support may be important in management of tuberculosis patients.

Content maybe subject to copyright    Report

Citations
More filters
Journal ArticleDOI
TL;DR: In the Kawempe Community Health Study, 872 culture-confirmed pulmonary TB cases and their 2,585 contacts were enrolled during 2002-2012 and followed for up to 2 years each, and risk factors for progression from exposure to infection and disease differ among children, women, and men.
Abstract: Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), remains a major public health problem. Household contact studies identify children and adults along the spectrum from Mtb exposure to disease. In the Kawempe Community Health Study (conducted in Kampala, Uganda), 872 culture-confirmed pulmonary TB cases and their 2,585 contacts were enrolled during 2002-2012 and followed for up to 2 years each. Risk factors identified by time-to-event analysis for secondary TB differed among children, women, and men. Younger age (P = 0.0061), human immunodeficiency virus (HIV) (P = 0.0002), thinness (P = 0.01), absent bacille Calmette-Guerin vaccination (P = 0.002), and epidemiologic risk score (P < 0.0001) were risks for children. For women, risks were HIV (P < 0.0001), thinness (World Health Organization criteria; P < 0.0001), and epidemiologic risk score (P = 0.003). For men, HIV (P = 0.0007) and low body mass index (P = 0.008) resulted in faster progression to TB. Tuberculin skin testing (TST) identified contacts with Mtb infection and those with persistently negative TST. Risks for faster time to Mtb infection were identified, and included age (P = 0.0007), baseline TST induration (P < 0.0001), and epidemiologic risk score (P < 0.0001) only in children. Those with persistently negative TST comprised 10% of contacts but had no unique epidemiologic characteristics among adults. The burden of Mtb infection and disease is high in TB households, and risk factors for progression from exposure to infection and disease differ among children, women, and men.

62 citations

Journal ArticleDOI
TL;DR: Though many individual factors differed across all three groups, an exposure risk score reflecting a collection of risk factors did not differ for PTST-, TSTC and TST + young children and adults.
Abstract: Despite sustained exposure to a person with pulmonary tuberculosis (TB), some M tuberculosis (Mtb) exposed individuals maintain a negative tuberculin skin test (TST) Our objective was to characterize these persistently negative TST (PTST-) individuals and compare them to TST converters (TSTC) and individuals who are TST positive at study enrollment During a TB household contact study in Kampala, Uganda, PTST-, TSTC, and TST + individuals were identified PTST- individuals maintained a negative TST over a 2 year observation period despite prolonged exposure to an infectious tuberculosis (TB) case Epidemiological and clinical characteristics were compared, a risk score developed by another group to capture risk for Mtb infection was computed, and an ordinal regression was performed When analyzed independently, epidemiological risk factors increased in prevalence from PTST- to TSTC to TST+ An ordinal regression model suggested age (p < 001), number of windows (p < 001) and people (p = 007) in the home, and sleeping in the same room (p < 001) were associated with PTST- and TSTC As these factors do not exist in isolation, we examined a risk score, which reflects an accumulation of risk factors This compound exposure score did not differ significantly between PTST-, TSTC, and TST+, except for the 5–15 age group (p = 0009) Though many individual factors differed across all three groups, an exposure risk score reflecting a collection of risk factors did not differ for PTST-, TSTC and TST + young children and adults This is the first study to rigorously characterize the epidemiologic risk profile of individuals with persistently negative TSTs despite close exposure to a person with TB Additional studies are needed to characterize possible epidemiologic and host factors associated with this phenotype

47 citations


Cites background from "Low nutrient intake among adult wom..."

  • ...Alternatively, unmeasured components of shared environment, such as nutrition [29,30] or quantity of Mtb bacilli in the air [31-33], may potentially explain why some individuals remain PTST-....

    [...]

Journal ArticleDOI
TL;DR: An assessment of the fat-free and fat mass provides valuable information about changes in body composition with weight gain or loss and physical activity, and during aging.
Abstract: Purpose of reviewBody mass index has been shown to be an imprecise measurement of fat-free and fat mass, and provides no information if weight changes occur as a result of a decrease in fat-free mass or an increase in fat mass. Recent findingsNon-invasive body composition methods (i.e. bioelectrical impedance analysis, air displacement plethysmography) can now be used to monitor fat-free and fat mass with weight gain and loss, and during aging. This review discusses body composition measurements in terms of ethnic differences, physical activity, and age, and the limitations of bedside techniques in obesity and abnormal hydration status. SummaryAn assessment of the fat-free and fat mass provides valuable information about changes in body composition with weight gain or loss and physical activity, and during aging. Non-invasive bedside techniques can now be used to evaluate the nutritional status of healthy and ill individuals.

37 citations

Journal ArticleDOI
TL;DR: There are many facets of this design that are appealing for modern genetic studies, including the simultaneous enrollment of related and unrelated individuals, closely and distantly related individuals, collection of extensive epidemiologic and phenotypic data, and evaluation of effects of shared environment and gene by environment interaction.
Abstract: Most genetic epidemiological study designs fall into one of two categories: family-based and population-based (case-control). However, recent advances in statistical genetics call for study designs that combine these two approaches. We describe the household contact study design as we have applied it in our several years of study of the epidemiology of tuberculosis. Though we highlight its applicability for genetic epidemiological studies of infectious diseases, there are many facets of this design that are appealing for modern genetic studies, including the simultaneous enrollment of related and unrelated individuals, closely and distantly related individuals, collection of extensive epidemiologic and phenotypic data, and evaluation of effects of shared environment and gene by environment interaction. These study design characteristics are particularly appealing for current sequencing studies.

22 citations

Journal ArticleDOI
TL;DR: Individual with MDR-TB demonstrated concomitantly decreased body weight and fat-free mass over time versus drug-sensitive TB patients, despite increased macronutrient intake, likely reflecting the catabolic effects of TB.

17 citations

References
More filters
Journal ArticleDOI
TL;DR: Some of the first estimates of the extent of the public health problem posed by sarcopenia are provided, independent of ethnicity, age, morbidity, obesity, income, and health behaviors.
Abstract: Muscle mass decreases with age, leading to "sarcopenia," or low relative muscle mass, in elderly people. Sarcopenia is believed to be associated with metabolic, physiologic, and functional impairments and disability. Methods of estimating the prevalence of sarcopenia and its associated risks in elderly populations are lacking. Data from a population-based survey of 883 elderly Hispanic and non-Hispanic white men and women living in New Mexico (the New Mexico Elder Health Survey, 1993-1995) were analyzed to develop a method for estimating the prevalence of sarcopenia. An anthropometric equation for predicting appendicular skeletal muscle mass was developed from a random subsample (n = 199) of participants and was extended to the total sample. Sarcopenia was defined as appendicular skeletal muscle mass (kg)/height2 (m2) being less than two standard deviations below the mean of a young reference group. Prevalences increased from 13-24% in persons under 70 years of age to >50% in persons over 80 years of age, and were slightly greater in Hispanics than in non-Hispanic whites. Sarcopenia was significantly associated with self-reported physical disability in both men and women, independent of ethnicity, age, morbidity, obesity, income, and health behaviors. This study provides some of the first estimates of the extent of the public health problem posed by sarcopenia.

3,478 citations


"Low nutrient intake among adult wom..." refers background in this paper

  • ...Height-normalized LMI and FMI eliminate differences in fat and fat-free mass associated with height [12,13]....

    [...]

Journal ArticleDOI
TL;DR: These findings indicate that FFMI and BFMI may be useful in nutritional assessment, and use of height-normalized indices, namely, a FFM index and a BFM index, together with basal oxygen-consumption rate, diagnosed PEM in 27 of the 32 Minnesota Study subjects after 12 wk of semi-starvation.

777 citations

Journal ArticleDOI
TL;DR: Reference intervals for FFMI and FMI could be of practical value for the clinical evaluation of a deficit in fat-free mass with or without excess fat mass (sarcopenic obesity) for a given age category, complementing the classical concept of body mass index (BMI) in a more qualitative manner.
Abstract: Objective: To determine reference values for fat-free mass index (FFMI) and fat mass index (FMI) in a large Caucasian group of apparently healthy subjects, as a function of age and gender and to develop percentile distribution for these two parameters. Design: Cross-sectional study in which bioelectrical impedance analysis (50 kHz) was measured (using tetrapolar electrodes and cross-validated formulae by dual-energy X-ray absorptiometry in order to calculate FFMI (fat-free mass/height squared) and FMI (fat mass/height squared). Subjects: A total of 5635 apparently healthy adults from a mixed non-randomly selected Caucasian population in Switzerland (2986 men and 2649 women), varying in age from 24 to 98 y. Results: The median FFMI (18–34 y) were 18.9 kg/m2 in young males and 15.4 kg/m2 in young females. No difference with age in males and a modest increase in females were observed. The median FMI was 4.0 kg/m2 in males and 5.5 kg/m2 in females. From young to elderly age categories, FMI progressively rose by an average of 55% in males and 62% in females, compared to an increase in body mass index (BMI) of 9 and 19% respectively. Conclusions: Reference intervals for FFMI and FMI could be of practical value for the clinical evaluation of a deficit in fat-free mass with or without excess fat mass (sarcopenic obesity) for a given age category, complementing the classical concept of body mass index (BMI) in a more qualitative manner. In contrast to BMI, similar reference ranges seems to be utilizable for FFMI with advancing age, in particular in men.

622 citations

Trending Questions (1)
Can we eat Maggi in tuberculosis?

Early tuberculosis diagnosis and nutritional support may be important in management of tuberculosis patients.